Etiological Classification of Underactive bladder

1. Peripheral Denervation or Neuropathy
   
   Pathophysiology: Decreased contractility – neural efferent or myogenic/decreased afferent stimulation.
   
   – Congenital, inflammatory, neoplastic or trauma lesion to peripheral nerves
   – Diabetes or other metabolic cause
   
2. Detrusor myopathy
   
   Pathophysiology: decreased contractility secondary to smooth muscle damage.
   
   -Fibrosis/collagen deposition
   -Inflammation/obstruction/overdistension
   
3. Pharmacological inhibition
   
   Pathophysiology: decreased contractility secondary to receptor blockade of neural efferents or afferents.
   
   – Antimuscarinics
   -Smooth muscle relaxants/spasmolytics/membrane stabilizers.
   
4. Pelvic floor overactivity